Individual
AMANDA GAITAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5535 S WILLIAMSON BLVD, SUITE 774, PORT ORANGE, FL 32128-8311
(386) 756-4395
(386) 944-7202
Mailing address
5535 S WILLIAMSON BLVD, SUITE 774, PORT ORANGE, FL 32128-8311
(386) 756-4395
(386) 944-7202
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2084778
TX
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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